Individual provider Active NPI

Jessica Yeager, DDS

  • Dentist
  • Fort Worth, TX
National Provider Identifier
1689992992
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
27402 Issued in TX
Practice address
7630 N Beach St Ste 130
Fort Worth, TX 76137-3018
Phone
(817) 485-7775
NPI assigned
May 11, 2010
Last updated
Sep 26, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 27402 TX Primary
General Practice Dentistry 1223G0001X DT-2402 HI

Addresses

Primary practice location

7630 N Beach St Ste 130
Fort Worth, TX 76137-3018

Mailing address

7630 N Beach St Ste 130
Fort Worth, TX 76137-3018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
27402TXMDDentist
DT-2402HIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Honu Dental General Practice Current Accepting new patients
Island Dental, LLC Dentist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1689992992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7630 N BEACH ST STE 130",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761373018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7630 N BEACH ST STE 130",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761373018",
            "telephone_number": "817-485-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEAGER",
        "first_name": "JESSICA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-11",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "27402",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT-2402",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.